Provider Demographics
NPI:1194782193
Name:COMMUNITY HOME HEALTHCARE INC
Entity type:Organization
Organization Name:COMMUNITY HOME HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:JACKSON-BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-393-1340
Mailing Address - Street 1:7528 W APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-1008
Mailing Address - Country:US
Mailing Address - Phone:414-393-1340
Mailing Address - Fax:414-393-1344
Practice Address - Street 1:7528 W APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-1008
Practice Address - Country:US
Practice Address - Phone:414-393-1340
Practice Address - Fax:414-393-1344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1046251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43114100Medicaid
WI527296Medicare Oscar/Certification